Abstract

The use of organs or tissue from one person to save the life or signiﬁcantly improve the health of another person has been a subject of debate among ethicists, lawyers, clinicians and the wider public for many years. Within thisjournal alone, in its four-year history there have beenseveral papers discussing the issue. 1 – 3 The undoubted need for organ donation is highlighted by the number of people actively waiting for a transplant in the UK (7868) and the disparity with the number of transplants carried out (3151 in the year 2008/9). 4 The most recent focus has been on the question of presumed consent forcadaveric transplantation and the recommendation of the Organ Donation Taskforce that ‘an opt out system should not be introduced into the UK at the present time’. 5In its report, the Task Force acknowledged the complex and multidimensional nature of organ donation. This complexity arises partly because of the range of methods by which organ donation can occur and the sources of organs for transplantation. These include the following:† Living donors related to the recipient of the organ;† Non-related living donors;† Paired or pooled donation where the potential donorand recipient are not tissue-compatible and thereforepaired with another donor and recipient to enable both recipients to receive a suitable organ;† Heart-beating cadaveric organ donation (where braindeath has occurred in the donor);† Non-heart-beating cadaveric organ donation wherebrain-stem death has not occurred but treatment iswithdrawn from the donor on the grounds of futility.The idea of an ethics group to advise health-care professionals on ethical issues that might arise in relation to organ donation and transplantation on a ‘day-to-daybasis’ has been suggested by Farrell. 1Currently, such ethics advice might be sought from a clinical ethics committee. In this Five-Minute Focus, we will explore some of the underlying ethical principles and perspectives that inform both the ongoing debate and current practice in relation to organ donation.